TY - JOUR
T1 - Sex Work Is Associated With Increased Vaginal Microbiome Diversity in Young Women From Mombasa, Kenya
AU - Sivro, Aida
AU - Mwatelah, Ruth
AU - Kambaran, Cheli
AU - Gebrebrhan, Henok
AU - Becker, Michael G.
AU - Ma, Huiting
AU - Klatt, Nichole R.
AU - Zevin, Alexander S.
AU - Kingʼola, Nzioki
AU - Wambua, Sammy
AU - Gichangi, Peter
AU - Cheuk, Eve
AU - McLaren, Paul J.
AU - Mishra, Sharmistha
AU - Becker, Marissa
AU - McKinnon, Lyle R.
N1 - Copyright:
This record is sourced from MEDLINE/PubMed, a database of the U.S. National Library of Medicine
PY - 2020/9/1
Y1 - 2020/9/1
N2 - BACKGROUND: While non-optimal vaginal bacteria and inflammation have been associated with increased HIV risk, the upstream drivers of these phenotypes are poorly defined in young African women.SETTING: Mombasa, Kenya.METHODS: We characterized vaginal microbiome and cytokine profiles of sexually active young women aged 14-24 years (n=168) in three study groups: those engaging in formal sex work, in transactional sex, and non-sex workers. Vaginal secretions were collected via self-inserted SoftCup, and assayed for cytokines and vaginal microbiome via multiplex ELISA and 16S rRNA sequencing, respectively. Epidemiological data were captured using a validated questionnaire.RESULTS: The median age of participants was 20 (IQR: 18-22). Approximately two-thirds of young women (105/168) had vaginal microbial communities characterized by Gardnerella and/or Prevotella spp.-dominance; a further 29% (49/168) were predominantly Lactobacillus iners. Microbiome clustering explained a large proportion of cytokine variation (>50% by the first 2 principle components). Age was not associated with vaginal microbial profiles in bivariable or multivariable analyses. Women self-identifying as sex workers had increased alpha (intra-individual) diversity, independent of age, recent sexual activity, HIV and other STIs (beta = 0.47, 95% CI: 0.05 - 0.90, p = 0.03). Recent sex (number of partners or sex acts last week, time since last vaginal sex) correlated with increased alpha diversity, particularly in participants who were not involved in sex work.CONCLUSION: Non-optimal vaginal microbiomes were common in young Kenyan women and associated with sex work and recent sexual activity, but independent of age. Restoring optimal vaginal microflora may represent a useful HIV prevention strategy.
AB - BACKGROUND: While non-optimal vaginal bacteria and inflammation have been associated with increased HIV risk, the upstream drivers of these phenotypes are poorly defined in young African women.SETTING: Mombasa, Kenya.METHODS: We characterized vaginal microbiome and cytokine profiles of sexually active young women aged 14-24 years (n=168) in three study groups: those engaging in formal sex work, in transactional sex, and non-sex workers. Vaginal secretions were collected via self-inserted SoftCup, and assayed for cytokines and vaginal microbiome via multiplex ELISA and 16S rRNA sequencing, respectively. Epidemiological data were captured using a validated questionnaire.RESULTS: The median age of participants was 20 (IQR: 18-22). Approximately two-thirds of young women (105/168) had vaginal microbial communities characterized by Gardnerella and/or Prevotella spp.-dominance; a further 29% (49/168) were predominantly Lactobacillus iners. Microbiome clustering explained a large proportion of cytokine variation (>50% by the first 2 principle components). Age was not associated with vaginal microbial profiles in bivariable or multivariable analyses. Women self-identifying as sex workers had increased alpha (intra-individual) diversity, independent of age, recent sexual activity, HIV and other STIs (beta = 0.47, 95% CI: 0.05 - 0.90, p = 0.03). Recent sex (number of partners or sex acts last week, time since last vaginal sex) correlated with increased alpha diversity, particularly in participants who were not involved in sex work.CONCLUSION: Non-optimal vaginal microbiomes were common in young Kenyan women and associated with sex work and recent sexual activity, but independent of age. Restoring optimal vaginal microflora may represent a useful HIV prevention strategy.
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U2 - 10.1097/QAI.0000000000002406
DO - 10.1097/QAI.0000000000002406
M3 - Article
C2 - 32433252
VL - 85
SP - 79
EP - 87
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - 1
ER -
